<i>Reply:</i>

Aragão, Máría de Fátima Viana Vasco; Gouveia, Mariana de Carvalho Leal; Fonseca, Tatiana; Filho, Ocelio Queiroga Cartaxo; Valença, Marcelo Moraes

doi:10.3174/ajnr.a6943

Cited by 5 publications

(23 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is suggestive of component of probably methemoglobin in this left olfactory bulb lesion which seems be little bigger and asymmetric compared with the apparently normal right olfactory bulb. 40 This asymmetry in size is better seen on FLAIR (B). 40 There is also a small round hyperintense lesion in the subcortical white matter in the left frontal lobe which is hypointense on T1WI (C, short arrow) and does not enhances on post-contrast T1WI (D, short arrow) being non specific 40 .…”

Section: Resultsmentioning

confidence: 92%

“…40 This asymmetry in size is better seen on FLAIR (B). 40 There is also a small round hyperintense lesion in the subcortical white matter in the left frontal lobe which is hypointense on T1WI (C, short arrow) and does not enhances on post-contrast T1WI (D, short arrow) being non specific 40 . The MRI done 3 months later shows on fat suppression T1 WI (E) that there is reduction on hyperintensity of left olfactory bulb lesion.…”

Section: Resultsmentioning

confidence: 92%

“… 40 – The figure 6 continuation of case 27: Her Chest CT (A) shows more than 50% of typical lung opacity of COVID 19 pulmonary injury, bilaterally (arrows). The MRI shows hyperintense lesion on 3D FLAIR (B, arrow) 40 and also on pre (C, arrow) 40 and post contrast SPGR T1 WI (D, arrow) 40 . This is suggestive of component of probably methemoglobin in this left olfactory bulb lesion which seems be little bigger and asymmetric compared with the apparently normal right olfactory bulb.…”

Section: Resultsmentioning

confidence: 99%

“…It is worth noting that in COVID-19 the "flu-like syndrome" and mild neurological symptoms 36 (e.g. headache, anosmia and ageusia) are very common, 37 but that these symptoms are usually transient, disappearing in around half of the cases within 15 days 38,39 and, for this reason, brain imaging (CT or MRI) is not regularly indicated for diagnostic clarification.…”

Section: Discussionmentioning

confidence: 99%

“…reported in various studies, from 5.1% to 88% of patient 38,39 . However, anosmia in the majority of studies is higher than the central nervous system symptoms which is reported to be around 25%.…”

Section: Covid-19 Patients Have Presented Symptoms Of Smell Dysfunctimentioning

confidence: 94%

See 4 more Smart Citations

Comparative Study - The Impact and Profile of COVID-19 Patients Who Are Indicated for Neuroimaging: Vascular Phenomena Are Been Found in the Brain and Olfactory Bulbs

Aragão

Leal

Filho

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

ObjectiveTo verify the impact and findings of the COVID-19 patients’ group that underwent brain scans in comparison to the group which only chest CT was performed.Method876 suspected COVID-19 patients and a subsample of 232 cases with confirmed COVID-19 who underwent brain CT/MRI scan (n=35) or only chest CT (n=197) in two radiology departments, were evaluated.Results5.59% of all suspected COVID-19 patients found had brain scans and 98.74% chest CT. There was a statistically significant difference with associations regarding the COVID-19 brain scan group for: admission to ICU, greater severity of lung injuries, the use of mechanical ventilator, seizure, sepsis, and stroke and statistical tendency for chronic renal failure and systemic arterial hypertension. 40.0% of COVID-19 patients from the brain scan group were abnormal on brain CT and/or brain MRI. 22.9% cases with any kind of bleeding or microbleeding, 8.6% with restricted diffusion lesions. One ischemic stroke case was associated with irregularity at M1 segment of the right middle cerebral artery. There was a case of left facial nerve palsy with enhancement of left geniculate ganglia. An analyse of the olfactory bulbs was possible in 12 brain MRIs and 100% had enhancement and/or microbleeding. There was no statistical difference regarding death (9.1% versus 5.2%).In conclusionthe COVID-19 patients group on which brain CT and/or MRI needed to be performed was statically associated with the more severe COVID-19 disease, an indication to ICU, a more severe form of lung disease, use of mechanical ventilator, seizure, sepsis and stroke. Less than half of patients had abnormal brain imaging scans with all of them showing vascular brain injury lesion, being more frequently microbleeding or bleeding, followed by restricted diffusion lesions. All the olfactory bulbs evaluated showed injury by vascular phenomenon, probably methahemoglobine by microbleeding or microthrombus and/or abnormal enhancement

show abstract

Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Covid-19 Patients Have Presented Symptoms Of Smell Dysfunctimentioning

confidence: 94%

See 3 more Smart Citations

Comparative Study - The Impact and Profile of COVID-19 Patients Who Are Indicated for Neuroimaging: Vascular Phenomena Are Been Found in the Brain and Olfactory Bulbs

Aragão

Leal

Filho

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Virtual Biopsy: A Reality Thanks to Advances in Radiology

Aragão¹,

Oliveira²,

Lima³

et al. 2021

AJNR Am J Neuroradiol

Self Cite

View full text Add to dashboard Cite

Reply:

Aragão

Andrade

Segundo

et al. 2021

AJNR Am J Neuroradiol

Self Cite

View full text Add to dashboard Cite

F irst, we would like to the thank authors of the new commentary, 1 which gave us the chance to reply to critics of our first publication 2 entitled "Anosmia in COVID-19 Associated with Injury to the Olfactory Bulbs Evident on MRI" written before the existence of anatomopathologic studies.Our research group had the opportunity to study and publish 3 other recent articles 3-5 about the same subject. In these articles, [3][4][5] we explained why we have interpreted 2 the alterations on brain imaging of patients with coronavirus disease 2019 (COVID-19) detected on thin slices of the coronal fat-suppressed T1WI, pre-and/or postcontrast, as olfactory bulb injuries (bloodbrain barrier and/or methemoglobin) and not artifacts. However, we will present these explanations again and also comment about some aspects of your Letter, 1 as follows:

show abstract

Reply:

Cited by 5 publications

References 6 publications

Comparative Study - The Impact and Profile of COVID-19 Patients Who Are Indicated for Neuroimaging: Vascular Phenomena Are Been Found in the Brain and Olfactory Bulbs

Comparative Study - The Impact and Profile of COVID-19 Patients Who Are Indicated for Neuroimaging: Vascular Phenomena Are Been Found in the Brain and Olfactory Bulbs

Virtual Biopsy: A Reality Thanks to Advances in Radiology

Reply:

Contact Info

Product

Resources

About